From the Guidelines
When switching from Mounjaro (tirzepatide) to Ozempic (semaglutide), patients should discontinue Mounjaro and start Ozempic at the initial dose of 0.25 mg once weekly for four weeks, then increase to 0.5 mg weekly, regardless of their previous tirzepatide dose. This approach is based on the understanding that GLP-1 receptor agonists, like semaglutide, have high glucose-lowering efficacy but with variations within the drug class 1. Given the structural differences and formulation of GLP-1 receptor agonists, including semaglutide, which is administered once weekly, it's crucial to follow a specific protocol to minimize potential side effects and ensure a smooth transition.
Key Considerations for the Switch
- The first Ozempic dose should be administered when the next Mounjaro dose would have been due, with no overlap period between medications.
- Patients may experience temporary changes in glycemic control or weight management effects during the transition.
- Close monitoring of blood glucose levels is essential, especially for diabetic patients, as GLP-1 receptor agonists can have varying effects on glucose control and may increase the hypoglycemic potential of other medications like insulin and sulfonylureas 1.
- Side effects such as nausea, vomiting, or diarrhea may occur or change in intensity during the switch, necessitating careful management and possibly dose adjustments.
- Maintaining consistent dietary and exercise habits throughout the transition is crucial to minimize fluctuations in glucose control and support the overall efficacy of the new medication regimen.
From the Research
Switching from Mounjaro to Ozempic
There are no specific studies that provide a recommended protocol for switching from Mounjaro (tirzepatide) to Ozempic (semaglutide). However, the following information may be helpful:
- The efficacy and safety of tirzepatide and semaglutide have been compared in several studies 2, 3.
- Tirzepatide has been shown to have a more potent effect on reducing HbA1c and body weight compared to semaglutide 2, 3.
- The most common adverse events associated with tirzepatide are gastrointestinal, and are dose-dependent 4.
- Semaglutide has also been shown to have a favorable safety profile, with a low incidence of serious adverse events 3.
Key Considerations
When considering switching from Mounjaro to Ozempic, the following factors should be taken into account:
- The patient's individual response to tirzepatide, including any adverse events or efficacy outcomes.
- The patient's medical history, including any comorbidities or concomitant medications.
- The potential for dose adjustments or titration when switching to semaglutide.
- The need for close monitoring of blood glucose levels and potential adjustments to concomitant medications.
Available Data
The available data on tirzepatide and semaglutide are primarily focused on their efficacy and safety in patients with type 2 diabetes, rather than on switching between the two medications 5, 2, 3, 6, 4. Therefore, any decision to switch from Mounjaro to Ozempic should be made on a case-by-case basis, taking into account the individual patient's needs and circumstances.